House Speaker Nancy Pelosi seen during a ground-breaking ceremony at Japantown's Nihonmachi Terrace in San Francisco, Calif., on Tuesday, September 1, 2009. Pelosi of San Francisco, is in the eye of the storm over health care reform in Washington. less

House Speaker Nancy Pelosi seen during a ground-breaking ceremony at Japantown's Nihonmachi Terrace in San Francisco, Calif., on Tuesday, September 1, 2009. Pelosi of San Francisco, is in the eye of the storm ... more

Photo: Carlos Avila Gonzalez, The Chronicle

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Speaker Pelosi administers the oath of Office to members of the 110th Congress, she invited children in attedance to join her up on stage. The 110th Congress opening day ceremonies as Nancy Pelosi is officially voted into office as Speaker of the House today. Event in, Washington, DC, on 1/4/07. Photo by: Michael Macor/ San Francisco Chronicle less

Speaker Pelosi administers the oath of Office to members of the 110th Congress, she invited children in attedance to join her up on stage. The 110th Congress opening day ceremonies as Nancy Pelosi is officially ... more

Photo: Michael Macor, The Chronicle

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Mayor Thomas D'Alesandro, Jr. in backseet of car with daughter Nancy and wife Nancy. (File photo scanned 11/13/02) Photo from 1948. Courtesy of the D'Alesandro family via the Baltimore Sun.

Mayor Thomas D'Alesandro, Jr. in backseet of car with daughter Nancy and wife Nancy. (File photo scanned 11/13/02) Photo from 1948. Courtesy of the D'Alesandro family via the Baltimore Sun.

Photo: Courtesy D'Alesandro Family

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House Speaker Nancy Pelosi, D-CA, speaks to reporters as Senate Majority Leader Harry Reid, D-NV, looks on in front of the West Wing after a meeting on Afghanistan and Pakistan with US President Barack Obama October 6, 2009 at the White House in Washington, DC. Obama Tuesday sat down with senior lawmakers driving a raging debate on US Afghan strategy, as he works towards a decision on whether to send thousands more troops to war. Democratic and Republican leaders plus top members of key congressional committees met the president at the White House touting sharply conflicting visions of the next steps in the unpopular eight-year US military operation. Obama is methodically working through an internal policy review after US commander General Stanley McChrystal warned the war could be lost within a year without more troops, and reportedly asked for 40,000 more men. AFP PHOTO/Mandel NGAN (Photo credit should read MANDEL NGAN/AFP/Getty Images) less

House Speaker Nancy Pelosi, D-CA, speaks to reporters as Senate Majority Leader Harry Reid, D-NV, looks on in front of the West Wing after a meeting on Afghanistan and Pakistan with US President Barack Obama ... more

Photo: Mandel Ngan, AFP/Getty Images

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Pelosi reaches her defining moment

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House Speaker Nancy Pelosi's heady days of adoration as the elegant grandmother who broke the marble ceiling two years ago are over.

Disliked by most Americans, she is Republicans' favorite foil: the totemic San Francisco liberal, stumbling through what-did-she-know-when CIA tempests and odd discourses on St. Augustine's abortion views. Pelosi is to Republicans what former House Speaker Newt Gingrich was to Democrats - a bull's-eye.

Even her rare loss of composure last month, tearing up at the memory of the 1978 slayings of San Francisco Mayor George Moscone and Supervisor Harvey Milk, was denounced as comparing criticism with assassination.

But for all the scars of Washington's blood-sport politics, this is Pelosi's moment. The levers of power are in Democratic hands and she harnesses hers to one end: enacting the most ambitious Democratic agenda since the 1960s, pointing the nation in what she calls a "new direction."

Soon she plans to move her party's lodestar promise - a complex overhaul of the $2.6 trillion health care system - to the House floor, amid deep divisions in her caucus and a ferocious Republican assault.

"I said to the members the other day, 'You were born for this moment. You are here for a reason,' " Pelosi, 69, said in an interview in her office, with its bank of televisions and stunning view of the Capitol Mall. "This is the path we have all been on ... and so we're here now. We have these decisions to make."

Much of what President Obama does or doesn't do - from health care to Afghanistan - will hinge on her calculation of what is achievable. She is the last bulwark defending the "public option" of a government-run health insurance plan and if Obama decides to jettison it, she will have to hold her party's left wing.

An intense politician who wears her emotions in public, whether it was the angry glare she shot at South Carolina Republican Rep. Joe Wilson's "You lie" outburst at a presidential address or her unabashed ardor for Obama (mocked on a "Pop Up Pelosi" YouTube video), Pelosi is easy to caricature and demonize. She lacks charisma. Her speaking style, muddied by tangents, is panned.

Still, for a politician of her stature she is remarkably authentic, retaining the earnest relentlessness she brought to Washington as a back-bencher two decades ago. A study in contradictions, she combines a street politics forged in Baltimore and tutorials from the late Democratic Rep. Phil Burton, a San Francisco political legend, with the drive of a moral calling informed by a deep Catholicism.

Considered the most powerful Democratic House speaker in memory, Pelosi's path is littered with those who underestimated the intelligence and toughness beneath the pearls and polite smiles.

"Nancy is the den mother," said former Rep. Vic Fazio of Sacramento, who served in the Democratic leadership. "As children, when Nancy's kids saw the look she shot at Wilson, they took off."

Pelosi may be a victim of her own success. She has moved such a flood of legislation - including a landmark climate change bill, a rewrite of food safety laws and an expansion of children's health care - that much of it has gone unnoticed amid larger battles over health care, a bank rescue and record fiscal stimulus.

Despite rumblings from Blue Dog Democratic conservatives that she needs to pay more heed to their political viability, most of her caucus sings her praises. Even Republicans acknowledge her skill at forging consensus in a brawling party. "She's strong and decisive and you know you don't want to cross her," said a former GOP leadership aide. "That's what you need as a leader."

Pelosi is a sausage maker, a job best not viewed too closely, and one unlikely to win popularity.

"It's about listening," Pelosi said, "seeing what members' concerns are and trying to address them. That's how you can legislate. It may not be the most appealing activity that people want to observe, but it's what we do."

At one end are liberals who threaten to walk from any health bill that lacks a public option. At the other are conservatives from former GOP strongholds, such as Rep. Parker Griffith, D-Ala., who boasted to constituents that if Pelosi doesn't like criticism from Blue Dogs, "I've got a gift certificate to the mental health center."

"That doesn't mean people don't flare," he said. "This is a business where people yell and shout, they scream, they walk out of rooms. That's all interesting, but when you get down to the decisions that have to be made and the positions that people need to take, she has remarkable relationships across members of all stripes."

Pelosi circulates constantly on the House floor and behind the scenes, cultivating, cajoling and calculating, in what she likes to call a "giant kaleidoscope," turning the mix of policies and politics to the point that will snare the magic 218 votes.

That's how she plans to pass a government-run insurance option in the House; it's why she warns the administration that Americans and the Congress won't support sending more troops to Afghanistan. Pelosi's national poll numbers are irrelevant as long as she remains secure among two constituencies: San Francisco voters and House Democrats.

"She has tremendous pressures to manage that caucus and her report card shouldn't be how she's viewed by the public at large because this is a nasty job," said former GOP Rep. Tom Davis of Virginia, who chaired the National Republican Congressional Committee. "It's 'can you move the legislation through.' She's doing the job as speaker at this point and executing on it."

Republicans liked Pelosi before she became a leader, Fazio said.

"It's hard not to," agreed Davis. "She's always been warm and courteous and fair in dealing with me."

Pelosi has a sense of humor and an intellectual curiosity often obscured in partisan standoffs. She can't wait to get her hands on "The Red Book," the inner musings and torments of the late Carl Jung, and she diverts herself by reading cookbooks that her husband, businessman Paul Pelosi, says she never uses.

Born into politics, Pelosi is the youngest of six children of former Baltimore mayor and five-term member of Congress Thomas D'Alesandro and his wife, Annunciata. The family was steeped in the politics of the city's Little Italy, with an abiding faith in the Catholic Church and the Democratic Party.

As a child, she helped with the "favor file" and by age 10 was handling constituent requests, according former Chronicle reporter Marc Sandalow's biography of her.

She arrived in San Francisco in 1969 with her husband, a city native whom she met while attending college in Washington, D.C.; raising five children before entering politics in mid life. Her children and seven grandchildren remain the focal point of her life outside politics.

She once told an interviewer that she is "not afraid of anything," saying, "If they can't take my children away, then I can handle it."

But she has serious problems communicating, said UC Berkeley linguist and Pelosi admirer George Lakoff. "She tries to be nice to people when she's talking but she's not an inspiring speaker and she's very bad at the framing of issues," he said.

Her close associates often tell her she should focus more on herself and her message, Pelosi said. "People don't know enough about what is being accomplished here and how it is getting done, and they take it for granted because the House always comes through."

But, she added, "I'm not here about me."

Pelosi says

Excerpts from The Chronicle's interview with House Speaker Nancy Pelosi last month:

On her strengths: "Building consensus. But being bold. It's not the lowest common denominator. It's the boldest position to address the needs of America's working families."

On compromise: "We all have our ideas and our beliefs that we bring to the table, but at some point you have to be fairly agnostic. I believed in single-payer (government health care) for 30 years. It's not going to be in the bill."

On health care reform: Town hall meetings in August were "interesting because I always say, 'Don't underestimate your opponent, but don't overestimate them either.' "

On her critics' attacks: "Whatever it is, it's their problem. I don't waste any energy on it. I really don't."

On her reading list: "Read about something completely different. My husband would laugh when I say this, but cookbooks and things like that. 'You read it,' he says, 'but why don't you do it?' I don't take a whole lot of time recharging but it's valuable to just be amused."

On her constituents: "Every day that I walk on the floor of the House to represent the people of San Francisco is exciting. Their giving me the latitude to be the speaker and spend time more nationally is a wonderful gift. But I never forget who I represent."

Pelosi's polling

House Speaker Nancy Pelosi's national approval rating hit a low last month with 38 percent of Americans holding a favorable view of her. But she rates higher than other congressional leaders.

Senate Majority Leader Harry Reid, D-Nev., is at 27 percent, GOP Senate leader Mitch McConnell of Kentucky is at 25 percent, and House Republican leader John Boehner of Ohio is at 21 percent.

Last year, Pelosi was elected to her 12th term representing San Francisco, receiving 72 percent of the vote.